Japanese Journal of Oral and Maxillofacial Surgery
Online ISSN : 2186-1579
Print ISSN : 0021-5163
ISSN-L : 0021-5163
Volume 45, Issue 5
Displaying 1-13 of 13 articles from this issue
  • Examination by comparative genomic hybridization
    Takayuki KOMIYAMA, Yuji MIYAHARA, Teruo AMAGASA, Hiroshi IWAKI, Yasush ...
    1999 Volume 45 Issue 5 Pages 313-316
    Published: May 20, 1999
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    Cancers are considered to be formed by a multi-hit process of malignant transformation, which involves culmination of a number of aberrant genetic events. Comparative genomic hybridization (CGH), a recently developed molecular cytogenetic method, was used to study seven oral squamous cell carcinomas (SCCs) surgically resected at our department, and to analyze regions with DNA copy number abnormalities.
    DNA copy number increases were observed on chromosome 8 p in all cases. Five of seven cases had increased DNA copy numbers on chromosomes llq and 13q, and four cases had increased DNA copy numbers on chromosomes 1 q, 3 q, 5 p, llp, and 20p. Four cases had decreased copy numbers on chromosome 18q. Amplification of oncogenes and loss of tumor suppressor genes on these chromosomes was apparently related to the development of oral SCCs. As CGH provides a global analysis of chromosomal changes and rapidly identifies regions with DNA copy number changes, it may be useful in the diagnosis and prognosis of oral cancers if more CGH data are collected.
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  • Naruki NISHIMATSU, Masahiro UMEDA, Yoshiki ISHIDA, Hiroshi MASAGO, Yas ...
    1999 Volume 45 Issue 5 Pages 317-323
    Published: May 20, 1999
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    Adenoid cystic carcinoma (ACC), a rare malignant tumor in the head and neck, invades diffusely and easily metastasizes to the lung, although the growth rate is very slow. A retrospective study was conducted in 30 patients with ACC to ascertain the actual frequency of pulmonary metastasis, the tumor doubling time of metastatic tumors, and the onset of metastasis. The following results were obtained:
    1) Of 30 patients with ACC, 21 had pulmonary metastases (4 initially and 17 during observation), 7 were free from metastases but not yet observed for 5 years, and 2 were free from metastases for 5 years or longer after initial treatment. The cumulative metastasis rates at 5 and 10 years were 70% and 100%, respectively.
    2) Patients with T 1 or T 2 tumors and with histologic evidence of a tubular or cribriform pattern had pulmonary metastases about 20 months later than those with T 3 or T 4 tumors and with histologic evidence of a solid pattern, but the final metastasis rate did not differ between these groups after a prolonged period.
    3) The tumor doubling time of metastastic tumors of ACC was 86 to 1064 days (mean, 393 days), which was much longer than that of most other malignant neoplasms reported previously.
    4) The onset of pulmonary metastasis was calculated to be much earlier (mean, 227 months) than the time of initial therapy.
    5) These findings indicate that treatment for ACC should take into account that most patients have pulmonary metastases at presentation.
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  • Highly invasive tongue carcinoma
    Hideo KUROKAWA, Yoshihiro YAMASHITA, Keiko MIURA, Shingo TOKUDOME, Min ...
    1999 Volume 45 Issue 5 Pages 324-328
    Published: May 20, 1999
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    The clinicopathological features of highly invasive carcinomas and nonhighly invasive carcinomas were studied for 76 squamous cell carcinomas of the tongue treated in our department from 1983 through 1995. Highly invasive carcinomas were defined as those showing grades 4 C or 4 D modes of invasion according to Yamamoto's classification. The results were as follows:
    1. Thirty-two cases (42.1%) were classified as highly invasive carcinoma; 17 of them (22.4%) had grade 4 C mode of invasion, and 15 (19.7%) had grade 4 D mode of invasion.
    2. According to the TNM system, the incidence of T 2 lesions in grade 4 C and 4 D carcinomas and the N positive rate in the grade 4 D carcinomas were higher than those in nonhighly invasive carcinomas.
    3. Delayed cervical lymph node metastasis was encountered more often in grade 4 D carcinomas than in carcinomas showing the other modes of invasion.
    4. Grade 4 C and 4 D carcinomas showed a trend toward lower differentiation and higher invasiveness. The rate of vascular invasion was higher in grade 4 D carcinomas than in carcinomas showing other modes of invasion.
    5. The 5-year cumulative survival rate for all patients was 63.3%. The 5-year cumulative survival rate for patients with carcinomas showing a mode of invasion of grades 1 to 3 was 74.6%, as compared with 46.3% and 53.3%, in patients with the grade 4 C and 4 D carcinomas, respectively.
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  • Fuminori KATOU, Nobukazu SHIRAI, Seishi ECHIGO, Katsutoshi MOTEGI
    1999 Volume 45 Issue 5 Pages 329-335
    Published: May 20, 1999
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    Microsurgical transfer of skin flaps is commonly done to repair defects after radical resection of oral tumors. However, the condition of the intraorally transferred skin flaps remains unclear. We histologically studied the characteristics of 13 frozen specimens obtained from intraorally transferred forearm flaps. Histopathological examination revealed marked epidermal hyperplasia and inflammatory cell infiltration in 11 cases. PAS staining showed the presence of fungal elements in those cases. Immunostaining identified the element as Candida albicans. In fungus-negative cases (two cases), mild epidermal hyperplasia and inflammatory cell infiltration were observed. Fungal culture studies of oral swabs obtained from histologically fungus-positive cases revealed characteristic features of Candida albicans, as evaluated with a API 20C Auxanogram kit. Candida albicans was not detected in histologically fungus-negative cases. Immunohistochemical studies demonstrated the infiltration of numerous immunocompetent cells to the dermis of fungus-positive cases, i. e., CD 4+, CD 8+, CD20+, CD68+, neutrophil elastase+, HLA-DR+ cells, and minimal infiltration of IgA+ and IgG+ cells. There were scattered CD 4 +, CD 8 +, HLA-DR+ cells, and elastase+ neutrophils in the epidermis of fungus-positive cases. Enumeration of Ki-67+ keratinocytes showed a 10-fold increase indicating epidermal proliferation. The results indicated that most intraorally transferred skin flaps had cutaneous candidiasis.
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  • Masayuki IWAKI, Naohiro HASIKAWA, Masanobu ONISHI, Masahiro WATO
    1999 Volume 45 Issue 5 Pages 336-338
    Published: May 20, 1999
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    We describe a case of acinic cell carcinoma of the palate in a 44-year-old woman.The tumor measured 13×13mm. It was a partially ulcerated polypoid mass arising in the left side of the palate. The tumor was excised, and there has been no evidence of recurrence or metastasis as of 3 year 3 months after surgery.
    Histologically, the tumor parenchyma formed multiple microcysts, and the tumor cells resembled intercalated duct cells with eosinophilic cytoplasm. Immunohistochemical staining of the tumor cells demonstrated positive reactions to high molecular weight keratin (HMK), epithelial membrane antigen (EMA), S-100 protein, lactoferrin, and lysozyme and negative reactions to actin, vimentin, and α-amylase.
    Although diagnosis was difficult, histopathologically the tumor was diagnosed as a rare atypical case of acinic cell carcinoma (microcystic type) on the basis of morphological and immunohistochemical features.
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  • Shinya YASUDA, Mitsuo NISHIDA, Ken-Ichiro MURAKAMI, Tadahiko IIZUKA
    1999 Volume 45 Issue 5 Pages 339-341
    Published: May 20, 1999
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    A case of acoustic neurinoma associated with oral symptoms is described. The patient was a 55-year-old woman with discomfort and hypesthesia of the left side of the mandibular gingiva, tongue, and buccal mucosa. She was referred to a neurosurgeon, because her history and symptoms suggested an intracranial neoplasm. The presence of a large acoustic neurinoma was observed in the left cerebellopontine angle on computed tomography and magnetic resonance imaging. The tumor was successfully removed, but the patient died of cardiovascular and respiratory insufficiency. The histological diagnosis was consistent with the clinical diagnosis. Hearing loss, dizziness, ear obstruction, and tinnitus are the major symptoms of this tumor. Thus, it is unfamiliar to oral and maxillofacial surgeons. However, trigeminal and facial nerve symptoms such as hypesthesia of the oral mucosa and facial skin may appear with tumor growth. Therefore, it should be included in the differential diagnosis in patients with symptoms suggesting involvement of the trigeminal and facial nerves.
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  • Akio KANO, Katsuya OHTAKE, Shin-ichi SASAKI, Astushi TAKANO, Kenji MOG ...
    1999 Volume 45 Issue 5 Pages 342-344
    Published: May 20, 1999
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    A benign cartilaginous tumor is an uncommon oral neoplasm that usually occurs in the hard palate, alveolar ridges, larynx, condyle, and coronoid process. In addition to these osseous locations, cartilaginous tumors may be found in the oral soft tissue. This report describes an osteochondroma arising in the tongue. A 79-year-old woman with a mass of the tongue was admitted to Gunma University Hospital. The patient stated that she first noticed the mass at the age of 15 years.
    The mass grew slowly and was asymptomatic. The lesion appeared as a pedunculated mass of about 15 mm in diameter on the dosal surface of the tongue. The overlying mucosa was elevated. The lesion was hard and freely movable. The clinical diagnosis was a benign tumor of the tongue. The patient was given local anesthesia, and the mass was removed along with a margin of normal tissue and the overlying mucosa. Postoperative healing was uneventful. During 4 years of follow-up, there has been no sign of recurrence. Microscopically, the tumor consisted of cartilaginous and bony tissues with areas of transition and contained stratified squamous epithelium. The pathologic diagnosis was osteochondroma of the tongue.
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  • Toru FUJISAWA, Yoshihiko FURUKI, Toshihiko TAKENOBU, Norio AYASAKA, Hi ...
    1999 Volume 45 Issue 5 Pages 345-347
    Published: May 20, 1999
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    Rupture of the internal carotid artery is difficult to treat by direct surgery. In such cases, endovascular embolization therapy may be especially useful. We report a ruptured internal carotid artery that occurred after radical neck dissection and was treated by embolization.
    A 66-year-old man with cancer of the oral floor (squamous cell carcinoma) and metastatic cervical lymph nodes (T 3 N 2 bM 0) was referred to our hospital. The internal carotid artery ruptured after radical neck dissection and hemorrhagic shock occurred subsequently. Arterial embolization was performed because hemostasis was not achieved by suture of the artery. The arterial bleeding was controlled, and no neurological complications occurred after embolization. This technique was useful and less invasive than surgery for emergency treatment.
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  • Megumi MATSUNO, Yasuhiro OKAZAKI, Hideaki KAGAMI, Toshio SHIGETOMI, To ...
    1999 Volume 45 Issue 5 Pages 348-350
    Published: May 20, 1999
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    A case of chronic graft-versus-host-disease (GVHD) associated with multiple hyperplastic changes of the oral mucosa is described. The patient was 14-year-old boy referred to our department because of oral dryness. He had a past history of acute lymphatic leukemia and bone marrow transplantation. After 1 month, skin lesions developed. GVHD was diagnosed on examination of a biopsy specimen. Subsequently, oral symptoms, such as lichenoid lesions, oral dryness, and bulla, also developed. During follow-up, hyperplastic lesions were observed on the right side of the buccal mucosa and soft palate. Biopsies were performed, and the condition of the buccal mucosa was diagnosed as papillary hyperplasia with candidal infection. The condition of the soft palate was diagnosed as papilloma. The results of immunohistochemical studies suggested a relationship between these hyperplastic regions and GVHD. At present, hyperplasia of the oral mucosa is not considered an oral manifestation of GVHD. However, chronic GVHD is an established risk factor for oral cancer. Hyperplastic lesions in the oral mucosa should therefore be cautiously followed up in patients with chronic GVHD.
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  • Hiroshi HASEGAWA, Makoto KANO, Hisashi KANNO, Eijyu SATOU, Masatoshi U ...
    1999 Volume 45 Issue 5 Pages 351-353
    Published: May 20, 1999
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    We report a case of non-clostridial gas gagrene caused by odontogenic infection.
    A 35-year-old man was referred to our hospital because of swelling in the neck and the anterior chest. Crepitation was evident beneath the skin and computed tomography (CT) showed abundant gas extending from the left parapharyngeal space and the bilateral submandibular space to the anterior chest through the neck. He was admitted immediately and underwent drainage from the cervical incision and surgical debridement with the administration of antibiotics. Hyperbaric oxygen treatment was performed from the day after the operation because clostridial gas gangrene could not be ruled out by microscopic examination. After treatment, the patient recovered and was discharged on the 44th postoperative day. Bacteriologic examination revealed Bacteroides buccae and anaerobic gram positive cocci.
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  • Hitoshi SATOH, Hiroki MIYATE, Mitsumasa YOKOTA, Hitomi KOIZUMI, Keigo ...
    1999 Volume 45 Issue 5 Pages 354-356
    Published: May 20, 1999
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    Recently, actinomycosis has become a relatively rare bacterial infection, which is difficult to diagnose when clinical symptoms are not typical. We report a rare case of actinomycosis arising in the maxilla that showed atypical symptoms and was suspected to be a benign tumor or osteomyelitis.
    The patient was a 53-year-old man referred for examination of a lesion in the left side of the maxilla. Intraoral examination showed a diffuse swelling and a purulent fistula in the left side of the maxillary premolar region. Computed tomography revealed an irregular radiolucent mass with small nodular components similar in density to bone. An odontogenic tumor or osteomyelitis was suspected. The clinical diagnosis was a benign tumor, and the lesion was enucleated by an intraoral approach with the patient under general anesthesia. The histopathological diagnosis was actinomycosis.
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  • Ken-ichiro HATA, Yoshihiro SAWAKI, Tomoo ODA, Hiroko HAGINO, Kensuke S ...
    1999 Volume 45 Issue 5 Pages 357-359
    Published: May 20, 1999
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    Distraction osteogenesis, developed for orthopedic surgery by Ilizarov et al; is effective for the treatment of maxillary and mandibular deformities. With this method, soft tissue is also distracted and there is little relapse after surgery. We describe a patient with microgenia who was treated by distraction osteogenesis using a submerged device.
    The patient was an 18-year-old woman with microgenia. After preoperative orthodontic treatment for 15 months, Le Fort I osteotomy of the maxilla and corticotomies on both sides of the mandibular angle were carried out with the placement of distraction devices. After 7 days (latency period), the mandibular angles were lengthened 0.9mm per day for 18 days, and the occlusion were improved. These devices were removed 10 days after the completion of lengthening, and the distracted bone was held stationary with a titanium miniplate to prevent relapse. No marked changes of occlusion were found after 15 months of follow-up by clinical and radiographic observation.
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  • Jun-ichiro NUKATA, Yumiko KODAMA, Hiromichi MATSUYAMA, Tatsushi MATSUM ...
    1999 Volume 45 Issue 5 Pages 360-362
    Published: May 20, 1999
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    Follicular cysts are frequently associated with a permanent tooth in the jaws, but rarely arise from deciduous teeth.
    We report on a 4-year-old boy with a follicular cyst of the second lower deciduous molar.
    On radiographic examination, an ovoid radiolucent area including a radiopaque mass considered to be the second deciduous molar was noted in the right mandibular region.
    The clinical diagnosis was a follicular cyst associated with the second lower deciduous molar, and the cyst and the second lower deciduous molar were removed.
    The final diagnosis was a follicular cyst originating from the second lower deciduous molar.
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